- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.17 / $3,908.01 / $13,841.56
| Facility | | $419.17 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $282.83 / $282.83 / $314.38
| Facility | 54 | $282.83 | $282.83 | $314.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,350.61 / $4,406.97 / $8,524.51
| Facility | | $3,350.61 | $4,406.97 | $8,524.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,257.44 / $1,257.44 / $1,257.44
| Facility | | $1,257.44 | $1,257.44 | $1,257.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $377.25 / $697.64 / $1,242.00
| Facility | | $377.25 | $697.64 | $1,242.00 |
- Facility/Professional
- Facility
- Modifier
- 54
- Low / Median / High Price
- $1,347.91 / $1,347.91 / $1,347.91
| Facility | 54 | $1,347.91 | $1,347.91 | $1,347.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.00 / $1,064.08 / $1,508.92
| Facility | | $775.00 | $1,064.08 | $1,508.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |